| NPI | 1568585271 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CO 53919) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: WI 46891-20) |
| 2084F0202X Psychiatry & Neurology, Forensic Psychiatry (Licence: CO 53919) | |
| Enumeration Date | 2007-04-09 |
| Last Update Date | 2014-06-24 |